PDF(Pubmed)
Abstract：
The Asia-Pacific countries are highly diverse in health and economic conditions that may impact vaccine access and uptake. Our study aimed to characterize patterns of health access to DTP-based combination vaccines in 10 countries from 2019 to 2022 using the IQVIA-MIDAS database. The availability, affordability, and accessibility were compared across countries by national health and economic performance indicators using Spearman\'s rank correlation coefficient. Our findings showed that the three aspects of access to DTP-based vaccines varied substantially in the Asia-Pacific region, with higher levels in countries with better health and economic performance. Affected by the COVID-19 pandemic, vaccine accessibility fluctuates significantly in lower-income countries, with DTP coverage rates falling by more than 14% in the Philippines and Indonesia between 2019 and 2021. For availability and affordability, Singapore and Malaysia from high-income groups were largely affected, which may be related to health expenditure as a percentage of gross domestic product (Coefficient = 0.39, p = 0.03). Our study indicates that greater attention needs to be paid to national health expenditure and routine immunization services to improve vaccine disparities and increase the robustness and resilience of the vaccine supply chain during public health emergencies.
摘要：
亚太国家在健康和经济条件上高度不同，可能会影响疫苗的获取和使用。我们的研究旨在使用IQVIA-MIDAS数据库描述2019年至2022年10个国家/地区基于DTP的联合疫苗的健康获取模式。可用性,负担能力，使用Spearman的等级相关系数，通过国家健康和经济绩效指标比较了各国的可及性。我们的研究结果表明，在亚太地区，获得基于DTP的疫苗的三个方面差异很大，在健康和经济表现更好的国家，水平更高。受COVID-19大流行的影响，在低收入国家，疫苗的可获得性波动很大，2019年至2021年，菲律宾和印度尼西亚的DTP覆盖率下降了14%以上。对于可用性和可负担性，来自高收入群体的新加坡和马来西亚受到很大影响，这可能与卫生支出占国内生产总值的百分比有关(系数=0.39，p=0.03)。我们的研究表明，需要更多地关注国家卫生支出和常规免疫服务，以改善疫苗差距，并在突发公共卫生事件期间提高疫苗供应链的稳健性和韧性。
